Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

Forms and Documents

Document Name	Status
Form 1 NCTN Satisfaction Survey Form	New
Form 1 Survey of Customer Satisfaction for DCCPS Fellows Form	New
Form 1 NCI Explore On Site (EXPOSE) Customer Satisfaction Survey Form	New
Form 1 2016 SPORE Administrators Workshop Evaluation Form and Instruction	New
Form 1 NCI OSFM Customer Satisfaction Shuttle Survey Form and Instruction	New
Form 1 Feedback of NCI'sResearch Resources Website Form and Instruction	New
Form 1 RAS Initiative Symposium Feedback Questionnaire Form and Instruction	New
Form 1 NCI Cohort Consortium Steering Committee Elections Form and Instruction	New
Form 1 Customer Satisfaction Survey for the Office of Management Policy and Compliance (OMPC) Form and Instruction	New
Form 1 NCI Stories of Discovery Customer Satisfaction Survey Form and Instruction	New
Form 1 2015 Cancer Center Directors Meeting Customer Satisfaction Survey Form and Instruction	New
Form 1 epidemiology and Genomics Research Program (EGRP) Communications Survey Form and Instruction	New
A2_Sub-studyApprovals.docx Supplementary Document	2014-06-26
A1_Sub-study Template.doc Supplementary Document	2014-06-26
SSB Generic NCI Fast Track Extension 3 11 14.docx Supporting Statement B	2014-06-26
SSA Generic NCI Fast Track Extension Finalized.docx Supporting Statement A	2014-06-26

IC Document Collections

IC ID	Document Title	Status
224442	NCTN Satisfaction Survey Form	New
224280	Survey of Customer Satisfaction for DCCPS Fellows Form	New
224076	NCI Explore On Site (EXPOSE) Customer Satisfaction Survey Form	New
223538	2016 SPORE Administrators Workshop Evaluation Form and Instruction	New
221142	NCI OSFM Customer Satisfaction Shuttle Survey Form and Instruction	New
220704	Feedback of NCI'sResearch Resources Website Form and Instruction	New
219511	RAS Initiative Symposium Feedback Questionnaire Form and Instruction	New
219251	NCI Cohort Consortium Steering Committee Elections Form and Instruction	New
218892	Customer Satisfaction Survey for the Office of Management Policy and Compliance (OMPC) Form and Instruction	New
215844	NCI Stories of Discovery Customer Satisfaction Survey Form and Instruction	New
215723	2015 Cancer Center Directors Meeting Customer Satisfaction Survey Form and Instruction	New
214921	NIAMS Website Redesign Card Sort Task Instruction	New
214259	epidemiology and Genomics Research Program (EGRP) Communications Survey Form and Instruction	New

ICR Details

OMB Control No: 0925-0642	ICR Reference No: 201406-0925-004
Status: Historical Active	Previous ICR Reference No: 201108-0925-002
Agency/Subagency: HHS/NIH	Agency Tracking No:
Title: Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/11/2014
	Date Received in OIRA: 06/26/2014
Terms of Clearance: OMB approves this collection for a period of three years. To request approval of information collections under this generic approval, the agency must do the following: 1) Unless an agency is using multiple modes of collection (e.g., paper forms and electronic submissions), provide a Generic Clearance Submission Template for each Instrument; 2) If the agency is using multiple modes of collection (e.g., paper forms and electronic submissions), the same Generic Clearance Submission Template may be used for both instruments; 3) each Generic Clearance Submission Template must be uploaded as a Supplementary document using a naming convention that allows the public to identify the associated instrument; 4) submit no more than five Generic Submission Templates with each request.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2017	36 Months From Approved	09/30/2014
Responses	19,500	0	6,500
Time Burden (Hours)	26,250	0	8,750
Cost Burden (Dollars)	0	0	0

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Abstract: This collection of information is necessary to enable NIH to garner customer and stakeholder feedback in an efficient, timely manner, in accordance with our commitment to improving service delivery. The information collected from our customers and stakeholders will help ensure that users have an effective, efficient, and satisfying experience with NIH's programs.

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Authorizing Statute(s): EO: EO 12862 Name/Subject of EO: SETTING CUSTOMER SERVICE STANDARDS
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 15133	03/18/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 32965	06/09/2014
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 13

IC Title	Form No.	Form Name
Customer Satisfaction Survey for the Office of Management Policy and Compliance (OMPC)	1	Attachment 1 OMPC Survey
RAS Initiative Symposium Feedback Questionnaire	1	RAS Survey Screenshots
NCTN Satisfaction Survey	1	NCTN Survey Screenshots
epidemiology and Genomics Research Program (EGRP) Communications Survey	1	Attachment 1 EGRP Communications Survey
NCI Cohort Consortium Steering Committee Elections	1	Survey Screenshot
2016 SPORE Administrators Workshop Evaluation	1	2016 SPORE Administrators Workshop Evaluation-Paper online combined
Survey of Customer Satisfaction for DCCPS Fellows	1	Fellows Survey Screenshot
NIAMS Website Redesign Card Sort Task	1	Cad Sort Screenshots
NCI Stories of Discovery Customer Satisfaction Survey	1	Attachment 2 Customer Satisfaction Interview Guide
NCI Explore On Site (EXPOSE) Customer Satisfaction Survey	1	Alumni Survey Questions
NCI OSFM Customer Satisfaction Shuttle Survey	1	Attachment A Survey
2015 Cancer Center Directors Meeting Customer Satisfaction Survey	1	2015 Cancer Center Directors Survey
Feedback of NCI'sResearch Resources Website	1	Attachment A NCI Research Resources FINAL interview protocol

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	19,500	6,500	0	13,000	0	0
Annual Time Burden (Hours)	26,250	8,750	0	17,500	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is an extension of a currently approved submission. There are no changes to this submission from the previously, approved submission. Additionally, there are no changes in the burden being requested.

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Annual Cost to Federal Government: $300,000

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 06/26/2014

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